Public Health Risks of Disasters Communication, Infrastructure, and Preparedness: Workshop Summary (2005) / Chapter Skim
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3 Preparedness and Response: Systems, Supplies, Staff, and Space
3 Preparedness and Response: Systems, Supplies, Staff, and Space
Pages 33-48
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From page 33... ...
, preparedness and response capabilities take on even greater importance. Tactical nuclear weapons, possibly obtainable in Western Europe, could destroy much of the human and physical infrastructure relied upon for a response effort; therefore, for local responders to provide even a minimal level of care for mass casualties, federal and state governments must provide supplemental assets.
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From page 34... ...
SYSTEMS During recent disasters in the United States, responders have encountered numerous problems, including confusion over the jurisdiction responsible for coordinating the response effort; an inability to communicate the vulnerabilities and risks before, during, and after the crisis; difficulties in getting responders to the disaster site while moving victims away from it; and problems distributing essential resources among those who need it most. To alleviate those problems during future responses, the U.S.
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From page 35... ...
With their HRSA cooperative agreements, hospitals are to focus on six areas: governance, regional surge capacity to treat victims, emergency medical services, hospital linkages to public health departments, education and preparedness training, and terrorism preparedness exercises. Interspersed throughout the hospital and public health focus areas are activities related to smallpox preparedness (DHHS, 2004a)
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From page 36... ...
Other than movement restriction, isolaDuring the 2003 Severe Acute tion, and other containment methods, the Respiratory Syndrome (SARS) epidemic, United States public health and medical 21st century information technology systems lacked means to protect the converged with 19th century public health public's health, e.g., no SARS-specific and medical practices.
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From page 37... ...
serves as the lead federal agency for medical response under the National Response Plan, in collaboration with the United States Public Health Service's (USPHS) Commissioned Corps Readiness Force, the Department of Veterans Affairs (VA)
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From page 38... ...
· Disaster Mortuary Operational Response Teams (DMORT) are composed of private funeral directors, medical examiners, coroners, patholo gists, forensic anthropologists, medical records technicians, finger print specialists, forensic odontologists, dental assistants, x-ray techni cians, mental health specialists, security and investigative personnel, and administrative support staff.
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From page 39... ...
establish alternate outpatient care facilities where victims can be treated with limited holding capacity (with the entire NDMS system deployed, team members can treat 224 inpatient and 4,500 outpatients per day in these facilities)
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From page 40... ...
Assessments are conducted as follows. First, a representative sample popu lation is identified so that results can be extrapolated to the larger community; second, interview teams, composed of staff and volunteers from local, state, A rapid needs assessment is a low cost, and regional health departments, adminstatistically sound, population-based ister community-specific surveys epidemiological tool that can be used through face-to-face interactions with following a disaster to provide affected community members; finally, emergency managers with accurate and interviews, data entry, and data analyreliable information about the needs of sis are completed within 48 hours.
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From page 41... ...
Wilson noted that health officials' current understanding of the population's health status is insufficient and that the development of a baseline database will allow health officials to immediately understand the health impacts of a disaster following a rapid needs assessment. Strategic National Stockpile With results from the rapid needs assessment, responders can begin to distribute supplies to communities affected by the disaster.
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From page 42... ...
On a positive note, atropine sulfate, pralidoxime chloride, and diazepam are known antidotes to the harmful effects of chemical nerve agents. To distribute nerve agent antidotes in a timely manner, the Centers for Disease Control and Prevention has established the ChemPak program, a voluntary project that provides funds to cities and states to place nerve agent antidotes in monitored storage containers for immediate use in the event of a chemical emergency.
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From page 43... ...
. The Department of Health and Human Under the CRI, participating cities Services has reached an agreement with are to develop a template for adminis the United States Postal Service to call tering supplies to affected residents, in upon their employees for direct corporating federal, state, and local residential delivery of antibiotics to those government officials, as well as fire, located in the disaster zone.
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From page 44... ...
To further revolutionize dispersion methods, Raub noted that DHHS has reached an agreement with the USPS to call upon their employees on a voluntary basis for direct residential delivery of antibiotics to those located in the disaster zone. This cooperative effort will provide the speed of penetration into the community that will be necessary to control a public health catastrophe.
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From page 45... ...
The federal government's goal is to According to Lew Stringer, even if all recruit and train 20,000 personnel, in human resources from the USPHS addition to the existing VA, USPHS, Commissioned Corps Readiness Force, DoD, and NDMS staffs. the Department of Veterans Affairs, and -- Lew Stringer the NDMS are deployed simultaneously, the United States does not have an adequate contingent of medical professionals to stage an effective WMD response.
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From page 46... ...
Furthermore, according to Wilson, in the months following the terrorist attacks, the NIEHS funded many initiatives to evaluate New York City residents' health status, including: monitoring residents' personal exposure, collecting and analyzing air and dust samples, conducting respiratory health studies, initiating epidemiology studies, providing residents with exposure information and fact sheets, and advising clinicians about the related clinical conditions known to be associated with the disaster site. While the training programs established for the September 11 response had an appreciable health effect on workers, the WETP is working to develop improved preparedness training for workers deployed in future responses.
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From page 47... ...
He further noted that his office is looking at some of the practices of the Veteran's Affairs hospitals and how these may be applicable to local hospitals, but he acknowledged that additional planning and study will have to be done. SPACE Along with improving response systems, acquiring adequate stockpiles of supplies, and recruiting, credentialing, and training response staff, it is just as important to ensure that sufficient physical space has been secured within which to successfully implement the medical response, observed Raub.
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From page 48... ...
Preparedness and response efforts can be strengthened through the collective wisdom of generalists and specialists in the private sector, scientific, academic, and industrial communities, as well as government officials at every level -- those who will ultimately coordinate, and be held accountable for, the events that occur before, during, and after disasters, concluded Wilson.
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